Smoking is associated with an increased risk of first and recurrent ventricular tachyarrhythmias in ischemic and nonischemic patients with mild heart failure: a MADIT-CRT substudy.

Autor:	Plank B; University of Rochester Medical Center, Rochester, New York., Kutyifa V; University of Rochester Medical Center, Rochester, New York., Moss AJ; University of Rochester Medical Center, Rochester, New York., Huang DT; University of Rochester Medical Center, Rochester, New York., Ruwald AC; University of Rochester Medical Center, Rochester, New York., McNitt S; University of Rochester Medical Center, Rochester, New York., Polonsky B; University of Rochester Medical Center, Rochester, New York., Zareba W; University of Rochester Medical Center, Rochester, New York., Goldenberg I; University of Rochester Medical Center, Rochester, New York., Aktas MK; University of Rochester Medical Center, Rochester, New York. Electronic address: Mehmet_Aktas@urmc.rochester.edu.
Jazyk:	angličtina
Zdroj:	Heart rhythm [Heart Rhythm] 2014 May; Vol. 11 (5), pp. 822-7. Date of Electronic Publication: 2014 Feb 06.
DOI:	10.1016/j.hrthm.2014.02.007
Abstrakt:	Background: Limited data exist regarding the proarrhythmic effects of smoking. Objective: To evaluate the relationship between smoking and the risk of first and recurrent ventricular tachyarrhythmias (VTAs) in patients with mild heart failure. Methods: The risk of a first and recurrent appropriate implantable cardioverter-defibrillator therapy for VTAs or death was compared between nonsmokers (n = 465), past smokers (n = 780), and current smokers (n = 197) in patients with ischemic and nonischemic cardiomyopathy who were enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy study. Results: The cumulative probability of a first VTA or death was significantly higher in current smokers than in past and nonsmokers (P < .001). Multivariate analysis showed that current smokers had a significantly higher risk of first ventricular tachycardia/ventricular fibrillation or death (hazard ratio [HR] 1.51; 95% confidence interval [CI] 1.14-2.01; P = .005) and a higher risk for first ventricular tachycardia/ventricular fibrillation episode (HR 1.54, 95% CI 1.12-2.13, P = .008) than did nonsmokers. Past smokers had a risk of first VTAs or death similar to that of nonsmokers (HR 1.01; 95% CI 0.80-1.27; P = .953). In comparison to nonsmokers, the risk of recurrent VTAs was significantly higher in the total cohort of patients (HR 1.54; 95% CI 1.21-1.95; P < .001) and in the subgroups of patients with ischemic and nonischemic cardiomyopathy (HR 1.48; 95% CI 1.03-2.13; P = .035). Conclusions: Current smokers with left ventricular dysfunction and mild heart failure are at a significantly higher risk of VTAs or death than are past smokers and nonsmokers. Smoking is associated with a significant increase in the risk of recurrent VTAs in both patients with ischemic and nonischemic cardiomyopathy. (Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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